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Patients with chronic immune thrombocytopenia treated with romiplostim may benefit from a higher starting dose when a rapid increase in count is needed, but it could be avoided in those with a prompt response to the standard dosage. We hypothesized that a platelet count ≥ 20 × 10 9 /l at baseline could distinguish subjects with such response from those with a delayed one during the early phase of treatment. Our work is a retrospective and single-institution analysis comparing the median platelet count, the median weekly dosage of romiplostim and the median number of weekly platelet counts < 50 × 10 9 /l between patients with a baseline ≥ 20 × 10 9 /l platelets (n=10, 2 splenectomized) and those with a lower one (n=8, 3 splenectomized) during the first month of treatment with romiplostim. The results show a higher median platelet count (79,5 vs 40,5 × 10 9 /l, p=0,002) and a lower median dose of romiplostim (1 vs 2 mcg/kg/week, p=0,01) in subjects with a baseline ≥ 20 × 10 9 /l platelets, who also had a trend of less weekly counts < 50 × 10 9 /l platelets (1 vs 2, p=0,054). These data suggest that patients with ≥ 20 × 10 9 /l platelets at baseline may achieve a prompt response with the standard dose of romiplostim, but further and larger data are needed in order to assess whether it can be considered in clinical practice.

mediterranean journal of hematology and infectious diseases

PATIENTS WITH ≥ 20 X 109/L PLATELETS AT BASELINE MAY HAVE A PROMPT RESPONSE TO ROMIPLOSTIM DURING THE EARLY PHASE OF TREATMENT: AN ITALIAN SINGLE-INSTITUTION EXPERIENCE